| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $67K | $0 | $67K | 3.52% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 5900 SAN MATEO, CA 94402 | RELIASTAR LIFE INSURANCE COMPANY | $128K | $0 | $128K | 10.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 3000 EXECUTIVE PARKWAY, SUITE 325 SAN RAMON, CA 94583 | RELIASTAR LIFE INSURANCE COMPANY | $3K | $0 | $3K | 0.23% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 2.59% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 511398 LOS ANGELES, CA 90051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $7K | $7K | 1.92% |
| PETER J MACE3 | 5775 EAST GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 1.72% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DRIVE, UNIT 208 WILMNGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $159 | $2K | 0.46% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE ROAD SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $66 | $2K | 0.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.28% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 511398 LOS ANGELES, CA 90051 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $9K | $0 | $9K | 8.21% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 511398 LOS ANGELES, CA 90051 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $53K | $0 | $53K | 57.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 15.58% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DRIVE, UNIT 208 WILMNGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $696 | $56 | $752 | 8.42% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE ROAD SUITE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $696 | $23 | $719 | 8.05% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 791 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 796 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,001 | $3.2M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 771 | $92K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 2,080 | $109K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 920 | $373K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 920 | $362K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 920 | $362K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,001 | $3.2M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 920 | $362K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,080 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.